Five Acholi districts have no hospital

Five out of eight districts that comprise Acholi Sub-region are operating without a hospital, a situation that has put several lives at a risk.The districts are Pader, Agago, and Lamwo all carved out of Kitgum, and Amuru and Omoro out of Gulu.Pader for instance, carved out of Kitgum in 2001, has been operating without a hospital for the past 17 years.“Yes we should be granted a hospital. There are many expectant mothers in need of the services of a gynaecologist. Whenever need arises we have no one on the ground,” says Ms Anna Apio, the acting District Health Officer.

Pader mainly relies on Pajule Health Centre IV in Pajule Sub-county for its major medical surgeries and emergencies where an ambulance and a clinical officer are deployed.A hospital offers specialised services and handles complicated cases which cannot be addressed at lower health centre level. Patients with complicated cases countrywide are referred to hospitals that have specialised doctors.Currently, patients brave long distances to seek appropriate treatment in the neighbouring districts of Kitgum, Gulu, Nwoya and sometimes Lira in Lango sub-region.

Besides that, Gulu National Referral Hospital and Kitgum Hospital are already stressed by the overwhelming patient turn up.The dilapidated Anaka Hospital in Nyowa Town, where some patients are being referred, has been non-functional.However, it is being rehabilitated after government secured Shs18.6b funding from World Bank under the Uganda health system strengthening project.Like Bugiri and Kiryandongo hospitals, Anaka was built by the Obotes government in the late 1960s although it was destroyed during the peak of the Lords Resistance Army (LRA)-led insurgency.

Major facilities of the hospital such as the outpatient department, female, male and children wards, maternity wards, mortuary, private wings and staff quarters have been non-functional for close to 25 years.Water and sewerage system had also run down due to wear and tear coupled with poor maintenance.Nwoya District was carved out of Amuru in 2010.Mr Patrick Okello Oryema, the Nwoya District chairperson, says the rehabilitation of the government hospital will save the community from the burden of seeking services in Gulu.

According to Mr Oryema, the hospital will also serve residents in Pakwach, Amuru and Oyam districts.The rationale behind the formation of new districts according to government is to extend services closer to the people. But most new districts are grappling with similar challenges of lack of adequate government funding and infrastructure among others.

DilemmaPader District leaders argue that the problem of lack of a hospital have been compounded by Health Ministry’s policy that requires a district to have a population of at least 500,000 people for a health centre to be elevated to a hospital status. Pader District population currently stands at 180,081, according to the 2016 National Population Census.The district has two health centre IVs with one of them in Acholipii for the UPDF.The district also has 13 health centre IIIs and 20 health centre IIs. Each of the health centre handles between 28 and 30 deliveries every month.

However, the district cannot recruit a gynaecologist since the Ministry of Health bars them from doing so. Mr Tito Okello, a resident of Pajule Town Council, says in 2016, he nearly lost his sight after he got involved in a motor accident and due to lack a health facility equipped with ophthalmologist in Pader. Mr Okello says he sought medical care at Gulu regional referral hospital which is a distance of about 106 kilometres from Pader. Mr Okello says in March, he lost his nephew who was involved in a road accident after he suffered from tetanus.

Long journeysMr Francis Toolit, another resident, says many patients are referred to either Gulu or Lira where there are better medical facilities which is a long distance. Some have to travel to Kitgum hospital which is 59 kms away.The Pader District vice chairperson, Mr Patrick Obua, says emergency cases cannot be handled due to lack of a hospital. “Securing an ambulance alone to refer a patient is a hassle that is why we are pleading for a hospital,” he says.

Mr Obua says last week they buried a mother and her baby after medical staff failed to secure an ambulance to transfer her from Angagura Health Centre III to Gulu Hospital.“The Ministry of Health’s policy that a district should be granted a hospital on grounds that it has half a million population should be revised for the sake of people’s lives,” he says.

He questions why districts such as Abim and Gulu have a hospital and yet their population is less than 500,000. However, the Health Minister, Dr Ruth Jane Aceng, says to upgrade a health centre into a district hospital, the government needs between Shs5b and Shs20b. “Such funds are required to equip the health facility and recruit workers among others,” she said.According to district authorities, many patients who need specialised attention are normally referred to Dr Ambrosoli Memorial Hospital in Agago District which was curved out of Pader in 2011.

More referralsAlthough government recently upgraded Anaka Hospital in Nwoya District, which was created in 2010, most patients are still being referred to St Mary’s Hospital Lacor and Gulu Regional Referral Hospital. Omoro with a population of 140,000 as per the 2013 household survey has a total of 20 health centre IIs, a health centre III and a health centre IV and seven health centre IIIs.The situation in Lamwo District is not any different as residents have to travel for two hours to Kitgum General Hospital or St Joseph’s hospital in Kitgum District.